Pre Operative Instructions for bone grafting
1. Start a Multivitamin of your choice, a Vitamin D supplement, and Calcium supplement today.
2. Take preoperative medications: 2 days prior to surgery
a. Antibiotic: (e. g. Omnicef, Augmentin, Amoxicillin, Cephalexin, Clindamycin).
b. Topical Antimicrobial mouth rinse: Chlorhexidine (Peridex) Oral Rinse & Nystatin Oral Rinse.
3. Contact the office if you have tenderness, throbbing pain or swelling in the area of the proposed procedure. The procedure may have to be delayed or changed.
Post Operative Instructions for Bone Grafting
1. Protection of the blood clot and surgical site
Slight bleeding after bone grafts is normal and may last for several hours. If bleeding is excessive then bite gently on folded gauze directly over bleeding area and replace as needed. If there is no active bleeding then leave the gauze out. Sit up or semi-recline. Avoid spitting, strenuous activity, bending over, sucking through a straw for 24 hours. No smoking for 48 hours.
2. Rinsing: Rinsing may dislodge the blood clot and interrupt the normal process of healing, so be gentle
Day 1 (Day of surgery – first 24 hours after surgery) Very gently rinse twice with chlorhexidine rinse.
Day 2-until healing is complete (Aproximately 6 weeks)
a. Rinse very gently using a glass of warm salt water (1/2 teaspoon per cup). Repeat rinsing 3 times a day.
b. Brush your teeth, 3 times a day, be gentle around the surgical sites.
c. Floss teeth. (be careful around surgical site.)
d. Follow with the chlorhexidine rinse 3 times a day, very gently.
3. Care of teeth / Cleanliness and healing
The teeth should be given their usual care. Brush three times a day. A clean mouth will heal faster. Be careful around the operative site, but still clean there. If the implant is protruding from the gums, use a cotton tipped applicator dipped in chlorhexidine to gently clean the exposed portion of the implant. Do not use a water pics, electric toothbrushes, toothpicks, plastic instruments or profy brushes around or on the implant for the first 6 months. The gingival attachment to the implant is not as strong as to a tooth.
4. Swelling / Fever
An ice pack placed on face will be beneficial to help control swelling and bleeding. If extreme swelling occurs or a temperature above 101.5 contact my office.
Some discomfort is normal following oral surgery. If pain medication is prescribed, take only as directed. Often it is beneficial to take the medication after eating to help prevent nausea. Do not drive while using narcotic pain medications.
6. No Smoking or Alcohol
Do not smoke or drink alcohol for 48 hours following oral surgery. This may cause the disruption of healthy blood clot formation and increase in complications such as wound breakdown and post-operative infections.
No hot liquids, acidic foods or drinks for the first 72 hours. Eat something when you feel ready. Cool liquids are best to start but avoid sucking through straws. Then, when the numbness starts to wear off, progress to a soft diet but do not chew in the area of the surgery.
8. Injection Site
After having intravenous anesthesia, the arm vein may become hardened and tender. Apply moist heat over the area for one hour three times a day for three days. Contact me if there is no improvement
9. Foil and Colla-Plug
If Biofoil was placed it should remain for 24-72 hours. If it is not adherent then remove it. If a Colla-Plug was placed do not rinse it out or drink alcoholic or acidic beverages or soda.
Nausea is a normal side effect of narcotic pain medications. If you have severe nausea or vomiting you may need to stop the pain medications or to take an additional anti-nausea medication.
11. Antibiotics and Contraception
Take antibiotic as prescribed until finished. Contraceptives may be ineffective while taking an antibiotic. Use extra protection.
12. Wearing your Prosthesis
Stent, partial dentures, flippers, or full dentures should be worn 24/7, immediately after surgery and for at least 10 days unless otherwise specified. Remove three times a day to clean then replace. Continue until gingiva (gums) cover site, and then wear at least 8hrs per day.
13. If you have a “Perio-Pak” (pink gum) Over the site, leave in for 48 hours.